The American Association of Colleges of Nursing (AACN) recommends that all advanced practice nurses, including nurse practitioners (NP), earn a Doctor of Nursing Practice (DNP) degree. The DNP provides an alternative to the research-based PhD and arms NPs with advanced skills in clinical practice and leadership.

Some schools have created DNP programs specifically for those NPs who already have a master of science in nursing (MSN). This article provides an overview of these MSN to DNP programs and summarizes three exemplar programs: Duke University, University of South Carolina

History of the DNP

In 2001, the Institute of Medicine (IOM) published their seminal report Crossing the Quality Chasm. Here, the IOM famously stated, “Health care harms patients too frequently and routinely fails to deliver its potential benefits. Indeed, between the health care
that we now have and the health care that we could have lies not just a gap, but a chasm.”

To close this chasm, the IOM recommended an amelioration of health care provider education. To everyone’s’ surprise, the IOM did not suggest more clinical or residency hours, instead, they implored physicians and nurse practitioners alike to focus on translational research, teamwork, and technology.

Without delay, the nursing profession took action. Their answer to the IOM’s call to action? The DNP. They designed the DNP degree to align with the IOM’s education reform and to target the increasingly complex needs of modern healthcare. The AACN developed The Essentials of Doctoral Education for Advanced Nursing Practice, which outlines the eight key elements required
by all DNP curriculums regardless of clinical specialty:

Scientific Underpinnings for Practice

Organizational and Systems Leadership

Clinical Scholarship and Analytical Methods;

Information Systems and Patient Care Technology

Health Care Policy

Interprofessional Collaboration

Clinical Prevention and Population Health

Advanced Nursing Practice

To emphasize their dedication to the IOM’s recommendations, the AACN designated the DNP as the terminal degree for nurse practitioners. In 2001, the University of Kentucky College of Nursing started the first DNP program. Today, there are more than 125 accredited DNP programs across the United States, and they are available in 48 states plus the District of Columbia.

Is the DNP Required for Nurse Practitioners?

In their Position Statement on the Practice Doctorate in Nursing, the AACN member institutions voted to move the level of preparation for nurse practitioners from an MSN to a DNP beginning in 2015. Some nurse leaders disagree with this requirement; therefore, the DNP remains an option for new providers.

In their 2014 report, The DNP by 2015, RAND Health investigated the institutional, political, and professional issues related to requiring the DNP. This report determined that the AACN needed to conduct outcomes studies on the impact of DNP patient care before making the degree a requirement. The report also concluded that the AACN needed to help employers understand the added competencies
and capabilities of DNP-educated NPs compared with MSN-educated NPs.

DNP vs. PhD

Both a PhD and a DNP are rigorous, challenging degrees; however, there are distinct differences. A PhD is considered a research doctorate that focuses on generating new knowledge. Nurse practitioners in PhD programs usually conduct original research and can pursue a variety of programs including nursing, economics, health policy, and human-computer interaction.

A DNP, on the other hand, is a practice doctorate that focuses on translating research into practice. A physician, for example, has a professional doctorate in medicine or osteopathy (MD & DO), a pharmacist has a professional doctorate in pharmacy (PharmD), and a physical therapist has a professional doctor in physical therapy (DPT).

Prerequisites for MSN to DNP Online Programs

If you want to be accepted into one of the online MSN to DNP programs, you’ll need to be a registered nurse (RN) and most often have your MSN degree in an advanced practice specialty area. MSN degrees from other health-related professions, such as in nursing administration or nursing informatics, could also be acceptable for some programs. Requirements for admission into an online MSN to DNP program could include:

A 3.0 GPA

A graduate-level research methods and statistics course

An e-portfolio of professional practice

A telephone or in-person interview

Certification in your advanced practice specialty when applicable

Letters or reference

Licensing as an RN

Resume or curriculum vitae

Statement of professional goals

Students will also need to meet technological requirements to do their coursework online. Some schools, such as the University of Arizona, specific these requirements online. The school suggests having a computer that is no less than two years old along with a soundcard and headphones, a CD/DVD player and microphone, and a video webcam. Students should be able to play MP4 and Windows Media Video files as well as
content that uses Flash. Most importantly, students should have a high-speed Internet connection.

Students will also need to have the means and time to travel, particularly if their online program is located some distance away from where they live. For example, the online DNP program at George Washington University, in Washington, D.C. requires students to be on campus three times. This includes an initial visit for an orientation, a visit between the first and second year to prepare for a
clinical research project and a project presentation at the end of the third year.

At Duke University, in Durham, N.C., on-campus sessions of two to three days are required during the first four semesters of the online MSN to DNP program. At the Medical University of South Carolina, in Charleston, health assessment courses may require on-campus visits. Students should
realize that no matter how ‘online’ their program is, they may still need to visit campus to complete certain requirements.

Courses and Curriculum for Online MSN to DNP Programs

Coursework for an online MSN to DNP program varies depending on what type of DNP program you choose. Be sure to look for a program that aligns with your goals and objectives. Classes that students in an MSN to DNP program could take include:

Applied Epidemiology and Biostatistics in Healthcare

Concepts in Population Health

Evidence-Based Practice

Healthcare Quality Improvement

Health Services Research and Policy

Informatics in Healthcare Delivery

Scientific Underpinnings for Practice

Students should realize that their online program will require the completion of clinical hours, which are site-based learning experiences that require in-person appearances. As the Medical University of South Carolina explains about its program: “Students can complete clinical experiences in a local community with an approved preceptor and clinical site. Students should be
prepared to travel to a clinical site. Students must also be prepared to work around the availability of the clinical site and preceptor.” Students may find similar guidelines in any of the programs they enroll for.

Duration of DNP Programs

For nurses who already have an MSN, the final step toward completing the DNP may just be 36 to 47 credit hours. Students in a DNP program typically need to complete 600 to 1,000 hours of clinical experience, but may be able to include hours completed during their MSN. These clinical hours must be completed in person at a clinical site or through the school if it features a medical center. Depending on the requirements of a selected online MSN to DNP program, students can expect
to take two to three years to complete their degree.

DNP Research Project

All DNP programs require the completion of a final research project that demonstrates clinical scholarship. Schools might refer to this project as a scholarly project, capstone project, thesis, dissertation, or final project. The AACN recommend that the final research project be termed “DNP Project” to avoid confusion with MSN Capstone Papers and PhD Theses.

The CCNE accredits bachelor’s, graduate and residency programs while the ACEN accredits diplomas, certificates and various degree-level programs, including the associate, bachelors, masters, post-masters certificate and clinical doctoral degrees. Students can find programs accredited program through the CCNE here and through the ACEN here. Students have the option to search for programs by state or by degree on each of these of these accrediting organizations’ web search pages.

National DNP Organization

The national DNP organization, DNP, Inc., was founded in November 2006 by a group of DNP students. They host an annual conference, and their website includes helpful links to previous student projects, job opportunities, and special interest groups. Their current president Dr. David Campbell-O’Dell is a family nurse practitioner and program director of the Colorado Technical University
College of Nursing. They also publish a free monthly newsletter called Outcomes .

List of Online MSN-to-DNP NP Programs

In addition to the MSN-to-DNP programs profiled at length in the section below, NursePractitionerSchools.com keeps a comprehensive database of all online NP programs in the U.S. All information (including tuition figures) is updated annually. Please note that to qualify as “online,” the program must require nine or fewer total campus visits.

State

Degree Level

School Type

Environment

Program 1: Duke University

The Duke University DNP program prepares NPs to assess published research to inform their practice and improve systems of care to influence patient outcomes. Duke is currently ranked as third by DNP program by the U.S. News and World Report. The entire curriculum is completed online with four executive on-campus sessions that last three days each.

Duke University specifically designed the program for working professionals, so that students could continue their job full-time while progressing through their courses. The Duke faculty are nationally renowned for their research, scholarship, and teaching with broad experiences in clinical practice, leadership, and patient safety.

Curriculum

The Duke University DNP curriculum consists of 15 courses and 35 credit hours. It is usually completed in 18 months. Students have the option of starting in either the Fall or the Spring. Applications for beginning in the Fall are due February 1 of each year and applications for beginning in the Spring are due May 1 of each year. All core courses are taught at the 900 level. They include:

Quantitative Methods

Evidence-Based Practice I

Evidence-Based Practice II

Transforming the Nation’s Health

Data Driven Health Care Improvements

Effective Leadership

Transformation of Health Care Systems

All students are required to complete a DNP project over four semesters. This research study must address a practice issue affecting groups of patients, health care organizations, or health care systems. Examples of projects completed by previous Duke University DNP students include:

Improving the Safety and Quality of Care for Newborns: Prevention of Severe Hyperbilirubinemia

Use of Clinical Decision Support Tool to Improve Guideline Adherence for the Treatment of Methicillin-Resistant Staphylococcus Aureus Skin and Soft Tissue Infections

Admission Requirements

Generally, admission into DNP programs is highly competitive. Duke University describes their ideal candidate as someone with an excellent collegiate grade point average, a desire to impact nursing practice, and strong leadership skills. Their specific admission criteria includes:

An MSN from a nationally accredited school of nursing.

Certification as an advanced practice nurse.

A grade point average of 3.0 or higher on a 4.0 scale.

Resume or curriculum vitae.

Current, unencumbered registered nurse license.

Proof of completion of a graduate level research methods and inferential statistics course.

Official transcripts from all post-secondary institutions.

Three letters of recommendation pertaining to the student’s academic ability, professional competence and personal character.

State of professional and career goals.

Telephone or in-person interview.

Online Experience

Duke University is well-known for their innovative use of technology to promote distance education. In fact, the U.S. News and World Report ranked them as the fifth best online graduate school of nursing. All of Duke’s DNP courses are offered online. Students are required to attend one in-person orientation and three in-person executive sessions (February, June, and October). These
on-campus sessions last 2-3 days and occur Thursday through Sunday.

Professors

Dr. Padilla is a family nurse practitioner and assistant professor at the Duke University School of Nursing. Her professional nursing experience includes trauma-critical care, emergency room, and primary care. Dr. Padilla has a strong interest in diabetes self-care, adherence, co-morbid depression, insulin initiation, and education. She teaches Evidence-Based Practice II in the DNP program.

Dr. Hockenberry is a pediatric nurse practitioner, professor of nursing, and associate dean for research affairs at Duke University School of Nursing. She is nationally renowned for her expertise in pediatric oncology and evidence-based practice methods. Dr. Hockenberry serves as one of the 11 chairs of the Duke Institutional Review Board, and she is actively involved with the school’s cancer-related research initiatives. She teaches Evidence-Based Practice I in the DNP
program.

The University of South Carolina College of Nursing has graduated over 9,300 nurses since 1957. In fact, they were the first accredited graduate nursing program in the state of South Carolina. Today, they possess a thriving research agenda with three focal areas: vulnerable populations, cancer survivorship, and health systems. Their DNP program is well-known across the country as the flagship university of the south.

Curriculum

The UMMC School of Nursing offers a unique program for nurses with an associate’s degree who wish to become a

Because the University of South Carolina is ranked number one by the U.S. News and World Report for best online graduate nursing programs, admission to their DNP program is highly competitive. Their courses are challenging, begging in at the 700 level and progressing up to the 800 level.

Admission Requirements

Admission to this DNP program is highly competitive. Their graduate program is ranked in the top 3% across the entire nation. The University of South Carolina’s website notes, “We seek highly qualified candidates who share our vision of excellence in education, practice, and scholarship.” The specific admission requirements for the
University of South Carolina DNP program include:

An MSN from an accredited college or university.

Minimum grade point average of 3.0 on a 4.0 scale from the previous Graduate degree.

Official transcript from all previously attended colleges or universities.

Three letters of reference from doctorally prepared nurses who can speak to the applicant’s ability to successfully complete the DNP program outcomes.

A personal goal statement that reflects DNP program outcomes.

Curriculum vitae.

Current, unencumbered registered nurse or advanced practice nurse license in the state of the applicant’s residence.

Online Experience

All courses are offered online through the learning management system Blackboard and Adobe Connect. Online classes are delivered asynchronously to accommodate varying personal and work schedules. Each online course has a virtual “Student Café” forum, which is a social space for introductions and informal chatting about any topic of interest throughout the semester. There is a mandatory student orientation held on-campus every August for new DNP students.

Professors

Dr. Andrews is a registered nurse and dean of the South Carolina College of Nursing. Dr. Andrews is renowned for her National Institutes of Health-funded research on cardiovascular risk reduction and tobacco control. She has authored over 200 publications, and she has served as a consultant for national task groups related to health and nursing. Dr. Andres mentors DNP students and teaches courses on research, theory, and health disparities.

Dr. Boyd is a registered nurse and associate professor at in the South Carolina College of Nursing. Her areas of scholarly interest include substance abuse, depression, victimization, posttraumatic stress disorder, and women’s health. Her research focuses on intimate partner violence and related homicides and suicides. In the DNP program, she teaches courses related to research methods.

The program includes 40 credit hours and 15 courses, usually completed in six semesters or two years of full-time study. Every course is completed online with a total of two weeks of on-campus meetings. Johns Hopkins is well known for their research on HIV/AIDS, global initiatives, intimate partner violence, nursing ethics, and community public-health.

Curriculum

The Johns Hopkins School of Nursing DNP curriculum encompasses 40 credit hours and 15 courses at the 800 level. The program can be completed in six semesters of full-time study, which includes two weeks of on-site classes each semester during the first year. Core courses include:

Foundation for Scholarship

Project Problem Identification

Analytical Approaches to Outcomes Management

Nursing Inquiry for Evidence-Based Practice

Translating Evidence into Practice

Project Development

Advanced Nursing Health Policy

Health Economics and Finance

Organizational and Systems Leadership for Quality Care

Clinical Data Management

Project Implementation

Clinical Data Management II

Project Evaluation

Descriptions of each of these courses can be found on the School of Nursing website. Students are also required to take two additional elective courses from either the School of Nursing, School of Medicine, Bloomberg School of Public Health, or the Carey Business School.

All students are required to complete a DNP Final Project. This project is the student’s original work that establishes them as a Hopkins Nursing clinical scholar. Upon completing the DNP Final Project, students engage in thoughtful reflection related to the project execution and identify opportunities for performance improvement.

Admission Requirements

Admission to the Johns Hopkins DNP program is highly competitive. Admissions criteria includes:

A BSN and MSN from a nationally accredited nursing program.

A grade point average of at least 3.0 on a 4.0 scale from both the BSN and MSN program.

Current and unencumbered registered nurse and NP license in the applicant’s state of residence.

Application fee of $100.

Three Letters of Recommendation.

Official transcripts from all previously attended colleges or universities.

Current resume or curriculum vitae.

Telephone or in-person interview.

Goal statement and project proposal that demonstrates a commitment to nursing practice and scholarly pursuit.

Identification of a mentor within the applicant’s practice setting who will provide meaningful consultation and guidance throughout the curriculum.

Johns Hopkins School of Nursing also requires all applicants to submit proof of completion of a three credit hour graduate level biostatistics course. Students must have earned a B or higher in this course, and they must be able to demonstrate evidence of statistical literacy and reasoning.

Professors

Dr. Donnelly is a dual certified adult and acute care nurse practitioner with a master’s degree in public health. She brings her expertise gained from 35 years of clinical practice to the classroom. She has worked with the British National Health Service and the Department of Defense in Japan and Italy. Dr. Donnelly has also served as an Assistant Director of Operations of a Johns Hopkins HMO. Her areas of scholarly interest encompass decreased cardiovascular risk
factors in urban populations.

Dr. Baptiste is a registered nurse with 15 years of clinical experience and assistant professor at the Johns Hopkins School of Nursing. She specializes in cardiovascular health and prevention in underserved populations. Dr. Baptiste has focused her scholarship on translating evidence-based practice to improve self-care behaviors among adults living with heart failure. She recently expanded her clinical practice to the Johns Hopkins Hospital adult emergency department,
where she serves as an evidence-based practice nurse consultant.

Dr. Melissa DeCapua, DNP, PMHNP-BC

Author

Melissa DeCapua is a board-certified psychiatric nurse practitioner who graduated from Vanderbilt University. She has a background in child and adolescent psychiatry as well as psychosomatic medicine. Uniquely, she also possesses a bachelor’s degree in studio arts, which she uses to enhance patient care, promote the nursing profession, and solve complex problems. Melissa currently works as the Healthcare Strategist at a Seattle-based health information technology company where
she guides product development by combining her clinical background and creative thinking. She is a strong advocate for empowering nurses, and she fiercely believes that nurses should play a pivotal role in shaping modern health care. For more about Melissa, check out her blog www.melissadecapua.com and follow her on Twitter @melissadecapua.